<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">手机号</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-mobile" data-rule="required" class="form-control" name="row[mobile]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label for="c-pid" class="control-label col-xs-12 col-sm-2">模板选择</label>
        <div class="col-xs-12 col-sm-8">

            <select id="c-pid" data-rule="required" class="form-control selectpicker" name="row[type]">
                <option data-type="" value="1" >翼生活</option>
                <option data-type="" value="2" >翼生活+权益</option>
            </select>

        </div>
    </div>
    <div class="form-group">
        <label for="c-content" class="control-label col-xs-12 col-sm-2">短信内容</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-content" class="form-control" name="row[content]" readonly style="height: 90px;">中国电信提醒您，前往微信点击链接领取翼生活代金券，全省链接：https://ty.jfxxl.net/?authorization=1，详情请拨打翼生活客服电话4001088679咨询，感谢您的支持，祝您生活愉快！回T退订</textarea>
        </div>
    </div>
    <div class="form-group goods" id="goods" style="display: none">
        <input type="hidden" name="row[goods_name]" class="goods_name">
        <label class="control-label col-xs-12 col-sm-2">{:__('权益商品')}:</label>
        <div class="col-xs-12 col-sm-8" >
        	<!-- <input id="c-name"  data-params='{"custom[is_enable]":"1"}'  data-source="coupon_code_goods/goods" class="form-control selectpage" name="row[name]" type="text" value=""> -->
            <input id="c-goods_id"  data-params='{"custom[is_enable]":"1","custom[coupon_id]":["like","5"]}'  data-source="coupon_code_goods/goods" class="form-control selectpage" name="row[goods_id]" type="text" value="">
        </div>
    </div>
    
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
 <!--    <script type="text/javascript">
    	
    </script> -->
</form>
